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Lawmakers making progress in talks on children's health care

Congressional negotiators are making progress towards a bipartisan deal to reauthorize children’s health insurance and several other important health-care programs, sources say.

Staff from the relevant committees in both parties and chambers met over the Thanksgiving break and are getting closer to an agreement, according to lobbyists and aides.

The package would include funding for the Children’s Health Insurance Program (CHIP) and community health centers, and an extension of a range of other expiring Medicare programs. It could also include a bipartisan bill from the Senate Finance Committee known as the Chronic Care Act that seeks to make Medicare spending more efficient and save money.

The health-care package could be attached to either a short-term government spending bill in early December, or the longer-term government funding bill later in December. Advocates are pushing for it to be included in the earlier, short-term bill.

Negotiators have made progress on a bipartisan agreement to pay for the extension of CHIP and other programs, which has been the main obstacle so far. Staff declined to specify what, exactly, the new offsets would be.

The CHIP funding in particular has led to both parties accusing the other of holding up funds for children’s health care, in part, due to a dispute on how to pay for it.

Earlier this month, the House passed a bill to fund CHIP and community health centers largely on a party-line vote. The Senate Finance Committee passed a bill to reauthorize CHIP, but hasn’t released their plan for how to pay for it.

The deadline to get money to states is rapidly approaching, though, and the year-end bills provide a vehicle for a deal.

Meanwhile, the Centers for Medicare and Medicaid Services has been redistributing funds to help hold states over while they wait for Congress to fund CHIP, which is jointly paid for by states and the federal government. The agency awarded nearly $607 million in total to states and U.S. territories in October and November.

Five states and Washington, D.C., could run out of funds by the end of December or early January, according to an Oct. 25 report from the Georgetown University Health Policy Institute’s Center for Children and Families.

States have been grappling with whether to send notices alerting families that coverage for their children could end. Nine million low-and middle-income children are covered by the program. On Monday, Colorado began sending out such letters, saying that the program would end in the state by Jan. 31 if federal funding isn’t renewed.

Community health centers are a large source of comprehensive primary care to around 26 million of the nation’s most vulnerable people. They haven’t yet seen reduced funds, but some of their grants first expire at the end of this year.

At issue is a fund Congress let expire Sept. 30 that consists of 70 percent of the centers' federal grant money. The uncertainty has worried health centers, leading them to make contingency plans. Some have already instituted hiring freezes and are examining scaling back services, laying off staff, reducing hours of operation and more.

A spokesperson for House Ways and Means Committee Republicans confirmed talks on passing policies like the committee's earlier Medicare "extenders" bill before the end of the year.

“The Ways and Means Committee is working to build off of the House-passed Medicare Part B Improvement Act, Committee-passed Medicare extenders, and the Ways and Means bipartisan extenders package," the spokesperson said.

"Working with our Senate counterparts, Committee Republicans and Democrats are discussing the path forward to ensure these important proposals are enacted into law before the end of the year.”